Individual
LUKAS BRETTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3801 MAIN DR STE B, FAYETTEVILLE, AR 72704-6364
(479) 856-6400
(479) 856-6623
Mailing address
3801 MAIN DR STE B, FAYETTEVILLE, AR 72704-6364
(479) 856-6400
(479) 856-6623
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194059721
—
AR
Enumeration date
11/08/2012
Last updated
11/08/2012
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